Provider Demographics
NPI:1588665715
Name:WINDER NURSING INC
Entity Type:Organization
Organization Name:WINDER NURSING INC
Other - Org Name:WINDER HEALTH CARE & REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WESTBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-867-2108
Mailing Address - Street 1:PO BOX 588
Mailing Address - Street 2:263 EAST MAY ST.
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-0588
Mailing Address - Country:US
Mailing Address - Phone:770-867-2108
Mailing Address - Fax:
Practice Address - Street 1:263 E MAY ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-7132
Practice Address - Country:US
Practice Address - Phone:770-867-2108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-007-1100314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00142854AMedicaid
GA00115536Medicare ID - Type Unspecified